Implementation Research on Hypertension Control to Prevent Dementia and Cognitive Decline (R61/R33 Clinical Trial Optional) | RFA AG 20 028

Opportunity Information: Apply for RFA AG 20 028

This National Institutes of Health (NIH) grant opportunity, titled "Implementation Research on Hypertension Control to Prevent Dementia and Cognitive Decline (R61/R33 Clinical Trial Optional)" (Funding Opportunity Number RFA-AG-20-028; CFDA 93.866), supports research that tests real-world, practical ways to improve hypertension treatment and blood pressure control in older adults who have multiple chronic conditions. The central idea is that better hypertension control can help prevent or delay downstream consequences such as mild cognitive impairment and dementia. The FOA specifically emphasizes dissemination and implementation research, meaning applicants are expected to focus not only on what treatment works in ideal settings, but on how to get effective hypertension control strategies adopted, delivered consistently, and sustained in everyday clinical and community environments.

A key feature of the announcement is its focus on pragmatic clinical trials. In practice, that means studies designed to operate under routine conditions with typical patients, clinicians, workflows, and health system constraints, rather than tightly controlled efficacy trials. The intent is to generate evidence that health systems and community partners can actually use: for example, strategies that improve prescribing and adherence to antihypertensive medications, strengthen follow-up and monitoring, reduce clinical inertia, and address barriers that older adults with multimorbidity face (such as polypharmacy, competing health priorities, functional limitations, and access challenges). While the clinical trial component is described as optional, the FOA clearly invites proposals involving pragmatic trials that evaluate implementation approaches in real care settings.

The population of interest is older adults with multimorbidity, a group that often experiences complex care needs and is at heightened risk for both cardiovascular and cognitive outcomes. Projects under this FOA are expected to connect hypertension control to brain health outcomes in a meaningful way, with attention to preventing cognitive decline and dementia-related sequelae. This does not necessarily mean every project must be a long dementia-incidence trial; rather, the FOA signals a strong interest in implementation strategies that can plausibly reduce cognitive risk and that measure relevant cognitive, functional, or health system outcomes aligned with that goal. The overall emphasis is on practical hypertension control strategies that can be scaled, sustained, and translated across settings serving older adults.

The award mechanism is an R61/R33 phased innovation structure. The R61 phase typically supports early, time-limited development or feasibility work needed to finalize an intervention package and implementation strategy, establish partnerships and workflows, and demonstrate readiness to proceed. The R33 phase generally supports the larger, more definitive pragmatic evaluation once prespecified milestones from the initial phase are met. This structure is meant to reduce risk by ensuring that key feasibility and implementation conditions are in place before moving into the main trial phase.

Eligibility is broad and includes many types of U.S.-based organizations: state, county, and local governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; public housing authorities/Indian housing authorities; Native American tribal organizations that are not federally recognized governments; nonprofit organizations with or without 501(c)(3) status (excluding higher education institutions where applicable); for-profit organizations (other than small businesses); and small businesses. The FOA also highlights additional eligible applicant categories such as Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISI), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), faith-based or community-based organizations, regional organizations, eligible federal agencies, tribal governments other than federally recognized, and U.S. territories or possessions. In terms of international involvement, non-U.S. organizations and non-U.S. institutions are not eligible to apply as the applicant organization, and non-domestic components of U.S. organizations are not eligible to apply; however, foreign components are allowed as defined by the NIH Grants Policy Statement, meaning a U.S. applicant may include certain international elements if justified and compliant with NIH policy.

Administrative details provided in the source include that this is a discretionary grant program administered by NIH, with an original closing date of October 22, 2019, and a posting/creation date of June 25, 2019. The award ceiling and expected number of awards are not specified in the provided data. Overall, the opportunity is geared toward teams that can combine hypertension care expertise, geriatrics and multimorbidity considerations, implementation science methods, and pragmatic trial design to produce actionable evidence on how to improve blood pressure control at scale as a strategy to protect cognitive health in aging populations.

• The National Institutes of Health in the health sector is offering a public funding opportunity titled "Implementation Research on Hypertension Control to Prevent Dementia and Cognitive Decline (R61/R33 Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.866.
• This funding opportunity was created on 2019-06-25.
• Applicants must submit their applications by 2019-10-22. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

Apply for RFA AG 20 028

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